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July 10, 2007

Comments

It's not a matter of competing statistics, Brendan. Gupta accused Moore of "fudging" the facts. If, at a minimum, there are "competing statistics," then Gupta is way out of line here and should apologize.

What Moore meant about Fahrenheit was that he was right about the war and that Blitzer was wrong.

Quibble all you want, and you will because that is all you ever do, but that fact does remaining standing above all others.

But you can't fact-check Michael Moore's work! Didn't you hear him tell Wolfe that everything in his film Fahrenheit 9/11 was proven true? And obviously if everything in Fahrenheit 9/11 was true then everything in Sicko will be proven true--and if you disagree with any of Moore's "facts" you will be branded, as in the case of the good doctor at CNN, a shill for big pharma.

Apparently, Gupta's fact checking was not so good:

http://www.prospect.org/csnc/blogs/beat_the_press_archive?month=07&year=2007&base_name=incompetent_health_care_coverav
via

http://www.thecarpetbaggerreport.com/archives/11399.html

the CB report makes an excellent point: this kind of fact checking would be extremely useful if it was 1) applied to things like the State of the Union, and 2) was actually accurate.

http://transcripts.cnn.com/TRANSCRIPTS/0707/10/lkl.01.html

I see a lot of Michael Moore fans coming on board here. The Spinsanity article on Fahrenheit 9/11 is excellent, because it illustrates rather well Moore's narrative style. He doesn't so much as lie overtly, but still is deceptive by presenting only some of the facts and not the entire picture. In short, he is the master of false impressions.

If CNN's factchecking of "Sicko" simply will not do, how about, then, a critique from the Associated Press?

http://www.usatoday.com/life/movies/2007-06-30-sicko-facts_N.htm

One Moore distortion:
Michael Moore notes dissaprovingly that the World Health Organiazation ranks the US as being in 37th place in terms of healthcare. What he fails to mention is that Cuba (the country that is highlighted in the film as having superior healthcare to the US) ranks 39 (Canada was ranked 30 on the list). Strangely enough, Moore didn't feel like mentioning these numbers in his latest film. Perhaps he did so out of time restraints.

I recommend reading AP's analysis on some of the shortcomings of the film.

What he fails to mention is that Cuba (the country that is highlighted in the film as having superior healthcare to the US) ranks 39

This fact is actually pretty prominently displayed in a the film, in a graphic that even appears in the trailer (did anyone here see the movie?).

And it doesn't really even contradict Moore's point in the film regarding Cuba, which is, essentially, if a crappy third world country like Cuba can do something like this, then so should the US.

I saw the trailer. Respectfully, the graphic you refer to is far from "prominent" in pointing out Cuba's ranking, or, for that matter, any of the other countries praised for their progressive healthcare systems in the documentary. Canada and the UK's rankings are blurs in that particular graphic.

Cuba is seen below Slovenia on the chart, but the attention of the viewer is clearly directed on the rank of the US on that list (it's highlighted, while Cuba's rank is darkened), nor does Moore make it a point to note Cuba's rank (or any other countries, well, except Slovenia).

In short, Moore did show the UK, Canada, and Cuba's rankings, but you'd have to be a speed reader, or looking for it, while the US and Slovenia's ranks are clearly marked and underlined. In magician's circles, this is known as "misdirection".

As for Moore's depiction of Cuba versus America's, if you find CNN or the Associate Press' treatment of the film erroneous or misleading, then how about an analysis from the New York Times?

http://www.nytimes.com/2007/05/27/weekinreview/27depalma.html?ex=1184299200&en=d009c10650d1db12&ei=5070

Obviously, as you and Moore have stated, Moore believes that Cuba's healthcare system is better than the US (why send 9/11 firefighters down there if this wasn't a point he wanted to highlight?), even though one of his own sources contradicts him.

Nonetheless, there are seemingly a number of problems with Moore's depiction of reality in the articles I've posted here, and you only point out a facet of one of them.


I disagree with Moore and don't think Cuba has a better system than we do right now (based, in part, on statistics I came across only after SiCKO sparked an interest. So good for SiCKO, I guess.)

I do, however, believe the Cuban system is, for the most part, on-par with what we have going on here (keeping in mind those WHO stats are more of a value analysis than a quality analysis, as they factor in per-capita spending on health care). If anything, the fact that a crappy, repressive communist dictatorship led by a violent ego-maniac is "just about as good" as the American system should be a a source of embarrassment, which is the overall point SiCKO makes.

I wanted to point out the Cuba ranking issue only cause it raises what I think is an all-too-common (and all-to-annoying) criticism against Moore, this idea that the people who see Michael Moore's movies are incapable of forming their own opinions outside of what they see explicitly stated in his films (I'm not the only person to notice Cuba below the US, its up there for four or five seconds in the film), and that Moore is somehow more disingenuous than other opinion journalists out there (from Charles Krauthammer to Lou Dobbs to Brendan Nyhan) simply because he editorializes facts to support a specific viewpoint. That's what opinion journalism is; Moore's contribution to the health care debate doesn't exist in a vacuum, and to act otherwise does a big disservice to both him and his work, and the people who watch these movies and enter them in to their larger media diet.

The AP, USA Today, CNN articles are all welcome and a part of this whole process (it's valuable for people to point out the downsides of socialized care, though I don't fault Moore for not including those downsides in his own film) but I don't like the way they are presented as some sort of discrediting of his work. If anything they are supplemental and reaffirming.

In any case, Moore himself refutes them here: http://www.michaelmoore.com/sicko/checkup/setting-the-record-straight/

And I've provided my own views on the CNN vs. Moore debate here (if you're interested): http://www.thedailysquid.com/

why send 9/11 firefighters down there if this wasn't a point he wanted to highlight?

And just to add, the rescue workers (none were firefighters, I don't think) were originally brought to Cuba in order to visit Guantanamo Bay, a bit of political theater designed to highlight the fact the suspected al qaeda terrorists in detention there have better access to health care than 9/11 rescue workers. The Cuban hospital visit was unplanned and came later.

You should really see the movie.

"If anything, the fact that a crappy, repressive communist dictatorship led by a violent ego-maniac is "just about as good" as the American system should be a a source of embarrassment, which is the overall point SiCKO makes."

But I'm not entirely certain that that is the point "Sicko" is making. Again, why did Moore specifically take 9/11 firefighters down to Cuba, if he thought they were going to get equal treatment than they did in the US? If Cuba and the US are equals in terms of healthcare, and that was Moore's main point, then why did they supposedly get better (and not the same) treatment than they would in the US?

Nor does your post address why Moore does not state Canada and the UK's ranking on the list presented in his movie (beyond an astonishing blur on the screen and Cuba's ranking is not highlighted or stated in the film).

It's certainly true that some viewers of Moore's work are free-thinkers, and don't take his films as the gospel truth. But that does not absolve Moore of criticism, if what he presents is not the entire picture. And there are many people who believe most of what he says.

In this film, Moore seems to suggest that the healthcare systems in France, Canada, Cuba, and the UK are better than the American one, while downplaying the negatives of socialized medicine. In some ways, healthcare is better in those countries, but that's not the whole story. For instance, significant percentages of Canadians and Brits have to wait considerably longer for certain health services than their American counterparts, yet Moore downplays that.

Obviously, Moore's film is an opinion piece. But it also uses facts, utilizes statistics, purports to be true, uses footage of real people and places and discusses issues in the real world. Doing so opens it up for criticism, if certain information is left out or the data presented in the film is misleading.

The fact that there is alternate info out there, or that Moore uses an obvious slant, does not make it immune to criticism, or any less disingenuous.

Otherwise, you couldn't criticize anybody. Bill O' Reilly? Sean Hannity? They present only certain facts on a number of issues, but, wait, they're opinion journalists. That means you can't discredit them or confront them on any of their distortions. What would Media Matters do in it's spare time?

I see you did address the "firefighter" issue, while I was writing and posting my comment. And you are correct, they were rescue workers, not fire fighters.

Well first off, the fact that that Canada is 30th on the WHO list and the UK 18th hardly contradicts Moore's view that those countries have superior systems to us at 37th (I also only know these stats because SiCKO inspired me to look up the list).

Obviously Moore (or Hannity or O'Reilly) shouldn't be absolved of criticism--opinion pieces only work when part of a larger discussion, of which criticism is a big part. I don't refute that (in fact that's largely what I was saying).

But highlighting this-or-that fact that Moore leaves out of his argument doesn't make his film bad, or misleading, and doesn't really illustrate that he's pulling the wool over anyone's eyes. Opinion journalism obviously works on a sliding scale, on one end of which is the blunt, artless analysis of Hannity and O'Reilly, on the other end of which are pundits like EJ Dionne and George Will. If you ask me, Moore tilts more toward the Dionne-Will side of things than the Hannity-O'Reilly, if only because his films are interesting and well made, and present compelling arguments.

If Moore has a compliment in the blogo-pundit-sphere, I'd say it's Andrew Sullivan; a passionate, at times infuriating analyst with funny and compelling opinion pieces that are artfully presented and which invite constructive scrutiny. It's the best type of journalism out there.

CNN is already backtracking about its criticisms of 'Sicko'. Moore may have bent the truth slightly in his other films to make a point; but his sentiments mostly hold true. And compared to the Bush Administration's transgressions, he comes off as a Saint.

The point of taking the 9/11 people to Cuba was the difference in accessibility between Cuba and the USA, not necessarily the quality of care. The point was that the US government is making healthcare accessible to the desperate characters at Gitmo that is not accessible to heroic workers at the 9/11 site.

It's not just ironic that this should be so, it makes one weep.

If you try to bury this point by quibbling over the different emphasis between numbers 37 and 39 in a list it is deceitful.

It's hard to blame Moore for using theatrics and blaring horns to make his points when he has to overcome this kind of knee jerk nitpicking and misdirection.

A major point that Sicko makes is that even when one sets aside the 40 million US citizens with NO health insurance and consider only those WITH health insurance that you discover that those people may not get medical care either.

The horrible thought is that some inaccessible bureaucrat (sometimes using a rubber stamp to apply a doctors signature) is making life and death decisions over patients lives and health. Isn't this EXACTLY the specter that has always been used to demonize government healthcare? Hasn't the private system become IN FACT the very soulless image of the dreaded government system?

To misrepresent Sickos point about accessibility is dishonest.

"If you try to bury this point by quibbling over the different emphasis between numbers 37 and 39 in a list it is deceitful."

I'm not trying to obfuscate any point of Moore by quibbling over statistics. If I am, so is CNN, the Associate Press, and the New York Times, hardly lackeys of the private healthcare industries. In addition, if I'm quibbling over statistics and being nitpicking, what about Moore? He's the one who wrote an incensed letter to CNN over the statistics. If criticizing Moore's data usage is mere pointless "nitpicking", why did Moore feel it necessary to challenge CNN's analysis.

CNN, by the way, has since posted a rebuttal to Moore's letter and his statements on CNN:

http://edition.cnn.com/2007/SHOWBIZ/Movies/07/15/moore.gupta/index.html

According to the news organization, Moore, in some cases, cherry picked facts from different sources rather than consistantly use info from the same sources. In short, he mixed and matched data from different soruces to make some of the points in the film.

Moore uses this data to back his points in the film. Flawed data (created on purpose or from sloppiness) can distort reality or misrepresent it. Three different news organizations found Moore's statistics flawed and his portrayal of some aspects of the healthcare systems here in the US and around the world problematic.

That should ring some alarms that Moore, at least, may not be entirely honest in his latest film.

Moore uses this data to back his points in the film. Flawed data (created on purpose or from sloppiness) can distort reality or misrepresent it. Three different news organizations found Moore's statistics flawed and his portrayal of some aspects of the healthcare systems here in the US and around the world problematic.


But they didn't really make this point. The facts CNN and others presented in order to refute those found in SiCKO actually support the reality Moore was arguing.

There isn't much of a difference between claiming US per capita spending on health care is a little over $6,000 (the older WHO data CNN cites) versus a little over $7,000 (the more recent HHS projection Moore cites); the reality still stands that that's a hell of a lot more than per capita in other countries. In fact, the Cuban $229 per capita spending CNN reported (another WHO number) is even more in line with Moore's argument than the $251 Moore cites in his movie (from the UN Human Development Report). If Moore was really cherry-picking data (as alleged) rather than using the most recent numbers available by reputable sources (as he claims), why wouldn't he have cited the (slightly older) $229 number?

It's annoying CNN, AP, NY Times etc. went after these more petty aspects aspects of the film, rather than simply presenting a contrary argument emphasizing some of the downsides of socialized medicine Moore didn't discuss (a choice he has openly admitted). Slate ran a great piece in refutation to the film by Austan Goolsbee, an economic advisor for Barack Obama, who made a lot of good points about the downsides of single-payer systems, why they wouldn't fly in the US, and which angles of the story Moore left out.

That's when the discussion goes from being petting quibbling to a full-on discussion on the issue. The MSM emphasis on objectivity prevented them from presenting something so obviously slanted (the Goolsbee piece is just as biased at the outset as is Moore's, in a good way) and in so doing missed a great opportunity to at once critique Moore's film, while still advancing the discussion.

This Billy Madison-esque "WHO is better...NO NO, HHS!" BS does nothing of the sort.

Here's that Slate article:

http://www.slate.com/id/2169454/fr/rss/

"There isn't much of a difference between claiming US per capita spending on health care is a little over $6,000 (the older WHO data CNN cites) versus a little over $7,000 (the more recent HHS projection Moore cites); the reality still stands that that's a hell of a lot more than per capita in other countries. In fact, the Cuban $229 per capita spending CNN reported (another WHO number) is even more in line with Moore's argument than the $251 Moore cites in his movie (from the UN Human Development Report)."

You miss the points that CNN is making. Moore used info to compare per capita of the US versus Cuba from two separate sources, the BBC (for the Cuban number, $251, which is the value used in the film) and the WHO value ($229) and the HHS projection (for the US number, $7092). From the beginning, Moore is being inconsistant, by picking data from two different reports and comparing them. That's one of the contentions CNN has with Moore (aka his sloppiness).

Of course, one might ask oneself why he insists on using the HHS number, rather than the one provided by the BBC source($5,711). Moore says the HHS numbers are more recent and thus more accurate (even though they are only projections0. But as any statician would tell you, to make a fair and valid comparison, one must compare statistics from the same set of data. You can't select data from one source and compare it to another.

Moore is either really sloppy (his legendary fact checkers were taking a nap) or he purposely wanted to exaggerate the disparity between the US for maximum effect (and took the numbers he wanted, aka "cherrypicking").

You may be correct in asserting there's still a large discrepancy between $251 and $5711, or not that great a difference between Moore's numbers and CNN, but Moore, obviously, fudges the numbers by using the higher HHS projection to compare to the ones provided by the BBC or even the WHO report. There's the issue.

You downplay the importance of Moore's statistical inaccuracies. But the fact remains that many will view Moore's film, see what they assume to be airtight statistics and data, and walk away with a potentially erroneous view of how healthcare functions in the US and abroad, reinforced by the statistics used by Moore.

In addition, I feel you exaggerate the uselessness of the news articles I selected (and, yes, I've read the Slate article you've listed previous to your posting). Besides noting statistical aberrations in Moore's film and website letter, they question some of the broader issues.

The CNN rebuttal notes that Gupta contests Moore's false impression in the film and on his site that universal health care is free (a viewpoint Goolsbee also questions). CNN also dispels Moore's conspiratorial notions about the medical expert CNN used in it's original report. Moore claims he's in cahoots with the pharmaceutical companies, the GOP, Bush, the evil private healthcare companies, etc.). It is not uncommon for Moore, in his films and books, to create these monoliths that he (representing the little man) must wrestle against (George Bush and the Saudis, GM, private healthcare).

From the AP article, you learn that Moore used higher numbers for the number of Americans who lack health insurance than actual current estimates, that Medicare's projected 10 year cost is actually lower than the one cited by Moore, that the director uses an atypical plan to lead the viewer into thinking that many American insurance plans won't cover a plethora of conditions and that it is the evil insurance companies who say what can be treated, that Americans wait shorter times than Canadians for medical care in all aspects of healthcare (despite the opposite impression Moore creates), and even criticizes Moore for not addressing whether Cuban citizens get the same care as the 9/11 rescue workers did in the film.

One more thing: Moore is an expert in false impressions. He may flash certain data on the screen and say all the truth and facts are there, but his editing and narrative, as any filmmaker knows,is what truly counts to a viewer, and it may lead the viewer to a whole other impression.

I didn't miss the point CNN was making, I explained the point right there in the parentheses. Moore claims to be using the most recent data from reputable sources, CNN says comparing data from different studies is sloppy and (somewhat) dishonest. Dean Baker, the co-director of Center for Economic and Policy Research (who Brendan mentions above) seems to think CNN's argument is off the mark. Here's a quote:

Actually, CNN's response is rather scary since it suggests that CNN has no one familiar with social science research on their staff. It is common to use data from different sources, when data from the same source is unavailable. If there is reason to believe that there are important differences between the methodology used by the different sources, then this should be noted. In this case, there do not appear to be any important differences in methodologies, only the year for which the estimate/projection is made.

I don't know any statisticians on a personal level, so I will believe Mr. Baker.

I also don't buy into this idea that the people who go see a Michael Moore movie aren't adult enough to form their own opinions on the views he presents. Moore's gotten plenty publicity (most of it unwarranted, if you ask me) for editorializing for effect to the point where people are healthily skeptical of his points going in, which is an entirely good thing (we should be so skeptical of all reporting).

Along these lines, the "free" thing is a weird one for me. Does Dr. Gupta really think we're all so dense as to not understand that government run programs are funded by taxes? How stupid does he think we are? And as if that wasn't bad enough, Moore actually discusses taxes directly at least twice in the film; the first when a Canadian politician reads from a charter associated with the founding of their health program, which includes the phrase "you are paying for this with your taxes," a quote which is read directly into the camera. Moore then goes to France, where he does an extended bit on how the French are "drowning in taxes" (a direct quote) which he then argues is not problematic since the average French family's biggest expense after house and car is "zee vegeetabulls," as his French guest explains, and how no one in France will go bankrupt because of health issues. You should really see this movie.

Moore's ultimate conclusion, the heart strings-pulling notion that we owe it to ourselves and our fellow citizens to provide universal coverage for every man, woman and child in a America, is a notion firmly rooted in the concept of government taxation. I know very few people who do not understand this very basic fact of how government operates, and it would be insulting (is insulting) for anyone to present a story that doesn't grant us at least this level of understanding.

That said, these reports do make some spotty good points here and there (though CNN actually owns up to the false notion that their medical expert's "only affiliation" is with Vanderbilt, admitting he is involved in a think tank chaired by Tommy Thompson, has done business with Aventis and Blue Cross, etc.). I just wish each report wasn't so small potatoes, especially when there are gaping holes in Moore's thesis to be contested with the same thought provoking, scrutiny-inviting arguments Moore puts forward in SiCKO.

"Along these lines, the "free" thing is a weird one for me. Does Dr. Gupta really think we're all so dense as to not understand that government run programs are funded by taxes? How stupid does he think we are? And as if that wasn't bad enough, Moore actually discusses taxes directly at least twice in the film; the first when a Canadian
politician reads from a charter associated with the founding of their health program, which includes the phrase "you are paying for this with your taxes," a quote which is read directly into the camera. Moore then goes to France, where he does an extended bit on how the French are "drowning in taxes" (a direct quote) which he then argues is not problematic since the average French family's biggest expense after house and car is "zee vegeetabulls," as his French guest explains, and how no one in France will go bankrupt because of health issues. You should really see this movie."

But Moore actually advocates "free" healthcare on his own website (via CNN):

http://www.michaelmoore.com/sicko/health-care-proposal/

And if Moore's point is that healthcare isn't free in the other countries and so blatantly obvious, why did so many reviewers of his film come away with the impression that it is, including Austan Goolsbee from your Slate article:

"Michael Moore's shtick cracks me up. As entertainment, most of his movies are great fun. In Sicko, though, he goes beyond his usual ranting. After spending the first half of the movie railing against the American health-care system, he actually puts forward a policy prescription. Moore thinks the United States should adopt a free, single-payer, national health system like Canada, the United Kingdom, France, or Cuba—socialized medicine, in the words of his critics."

Why did the Christian Science Monitor come across with that impression?

http://www.csmonitor.com/2007/0629/p15s01-almo.html

And why did this blogger, who saw the movie, come away with the impression that healthcare in other countries are free?

http://www.blogsnh.com/drupal/blog_entry/daniel_hynds/you_re_such_a_sicko

The examples go on and on. Now, why and how did these people come under the impression that Moore is advocating free healthcare or that it's free in other countries? Are they dense? Or did Moore create an overall false impression in his viewers that healthcare in other countries is "free"?

Remember, on Moore's own website, he calls for "free" healthcare. And there's a scene in "Sicko" where he searches for a cash register in a British hospital but only finds one devoted to paying for the traveling expenses of its patients. Why include such a scene,if Moore's big point is that socialized medicine has a cost?

Don't ask Gupta how stupid he thinks we are. Ask Moore.

I would also like to add that some people (like Goolsbee and yourself) do see through the myth that healthcare in Europe is "free". But it is an impression Moore makes in his film (so many reviewers certainly thought that's what Moore was saying in his film, and Moore advocates "free" healthcare on his website). And some people do fall for it (see the blogger I cited in my above post).

We use the word "free" because, at the point of service, it IS free. That's why people, including Moore, these bloggers, Austan Goolsbee, and even CNN, refer to it as "free" health care from time to time. Ask any of these people where the money comes and they'll tell you "from our taxes."

Nobody is under the impression that instituting Universal Health Care implements a magical program where money isn't involved. Everyone knows this is funded by taxes. We call it free because, when you use it, you don't pay any money. That doesn't change the fundamental understanding that the services are paid for by government funds.

Austan Goolsbee understands this in his Slate article, where he says:

At the most simplistic level, giving free health care to everyone costs a lot of money...

That's not a contradiction if you get past the semantics game and recognize "free healthcare" means "free at the point of service."

If Moore was trying to dupe everyone into believing universal health care didn't require any money, why would he harp on per-capita health care spending? Why would he discuss the high taxes the French pay? Why would he frame universal health care as a gift the American people should give to themselves?

You should really see this movie.

"We use the word "free" because, at the point of service, it IS free. That's why people, including Moore, these bloggers, Austan Goolsbee, and even CNN, refer to it as "free" health care from time to time. Ask any of these people where the money comes and they'll tell you "from our taxes."

Nobody is under the impression that instituting Universal Health Care implements a magical program where money isn't involved. Everyone knows this is funded by taxes. We call it free because, when you use it, you don't pay any money. That doesn't change the fundamental understanding that the services are paid for by government funds."

I'm not certain how you know that the blogger I cited is aware of the costs of "free healthcare", considering he makes no mention of it in his post. He does marvel at the sheer wonder of free healthcare in other countries, though.

The issue, however, is not whether Moore, CNN, you, I, or Goolsbie are aware of the costs of supposedly free healthcare. The issue is: what is the overall impression Moore is trying to create in his viewers about the costs of healthcare in other countries versus the US?

Many educated reviewers walked away from the film with the impression that Moore, in "Sicko", was trying to say healthcare in Canada, Cuba, and much of Europe was "free". Take this review of the film in "The Toronto Star":

http://www.thestar.com/article/230677

I quote:
"These and many other sad and shocking stories are contrasted with scenes of the enlightened Utopias in other countries, where Medicare is "free" – if you ignore the fact, as Moore does, that high taxes and long wait times pay for that "free" care."

Peter Howell, who saw the film and wrote the review for the Star, is clearly under the impression that Moore, in the film, is trying to say "free" healthcare has little to no cost. As does CNN and Goolsbie.

Now how do they get that impression, despite Moore's mentioning of the US per capita spending on healthcare, that the French are heavily taxed, or the footage of the Canadian politician? True, none of those reviewers are under the assumption that "free" healthcare is without its costs, but these reviewers do get the impression that that's what Moore is depicting. Surely, such an impression is not stupidity or accidental.

In addition, you scoff the notion that people may be ignorant of the costs of "free" healthcare, but there are people who will believe anything they're told, if it's artfully produced and edited. There are people who think "Loose Change" (http://www.loosechange911.com/), a film that purports the US government was behind 9/11, is factually accurate. In a 2003 poll, a third of Germans under the age of thirty believed the US masterminded 9/11.

If you have people who believe in all that, despite the wealth of info available out there to the contrary, do you think everybody will see through the fallacies of Moore's film, or will memorize the few segments where Moore mentions the costs of "free" healthcare? Will they fastidiously note every fact, statement, or clip Moore puts up on the screen, or will they go with the big picture, the overall impression that Moore wants to leave on the viewer? Will they duly note Cuba's ranking as no. 39 under the US, or will they be listening to the narrator and looking only at the US' highlighted rank over Slovenia?

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